• Investigative Magnetic Resonance Imaging
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• v.18 no.4
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• pp.290-302
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• 2014

Purpose : Susceptibility-weighted magnetic resonance (MR) sequence is three-dimensional (3D), spoiled gradient-echo pulse sequences that provide a high sensitivity for the detection of blood degradation products, calcifications, and iron deposits. This pictorial review is aimed at illustrating and discussing its main clinical applications. Materials and Methods: SWI is based on high-resolution, 3D, fully velocity-compensated gradient-echo sequences using both magnitude and phase images. To enhance the visibility of the venous structures, the magnitude images are multiplied with a phase mask generated from the filtered phase data, which are displayed at best after post-processing of the 3D dataset with the minimal intensity projection algorithm. A total of 200 patients underwent MR examinations that included SWI on a 3 tesla MR imager were enrolled. Results: SWI is very useful in detecting multiple brain disorders. Among the 200 patients, 80 showed developmental venous anomaly, 22 showed cavernous malformation, 12 showed calcifications in various conditions, 21 showed cerebrovascular accident with susceptibility vessel sign or microbleeds, 52 showed brain tumors, 2 showed diffuse axonal injury, 3 showed arteriovenous malformation, 5 showed dural arteriovenous fistula, 1 showed moyamoya disease, and 2 showed Parkinson's disease. Conclusion: SWI is useful in detecting occult low flow vascular lesions, calcification and microbleed and characterising diverse brain disorders.

• Journal of Acupuncture Research
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• v.18 no.4
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• pp.46-54
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• 2001

Objective : To study correlation of the brain areas with acupoints used in the treatment of cerebrovascular diseases to evaluate the hypothesis that selecting acupoints on the left side to treat disorders on the right side and vice versa is known as the crossing combination of acupoints. Materials and Methods: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 5 normal male volunteers (age range from 27 to 30 years) using acupuncture at acupoint, LI4 located in the left hand. In the control study, needle location was chosen on a non-meridian focus 1cm posterior to the right fibular head. All images were spatially normalized and the differences between rest and acupuncture stimulation were statistically analyzed using SPM(R) for Windows(R). Results : Acupuncture applied at LI4 located in the left hand increased rCBF in the right hemisphere, that is, the right parietal lobe(angular gyrus) and a part of the right middle posterior temporal gyrus and the right inferior occipital lobe. In the control stimulation, no significant rCBF increase was observed. Conclusion : The results demonstrated a correlation between stimulation at acupoint with increase in rCBF to the controlateral hemisphere.

• Journal of agricultural medicine and community health
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• v.35 no.4
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• pp.405-416
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• 2010

Objectives: This study was conducted to evaluate factors related to the degree of disability of stroke patients in a rural community. Methods: The study subjects included 641 patients selected from 975 stroke patients over the age of 50 with brain lesion-related disabilities living in Gyeongju, Korea, an urban-rural consolidated community. The data were obtained by interviews from July to October 2008. The subjects were divided into a seriously disabled group (1st and 2nd disability grade) and mildly disabled group (3th, 4th, 5th and 6th disability grade) by degree of disability according to registered disability grade. The collected data were analyzed using the SPSS 14.0 statistical package. Results: The study subjects included 379 males (59.1%) and 262 females (40.9%), and most patients were in their 70s (256 cases, 39.9%). The seriously disabled group included 287 patients (44.8%) and the mildly disabled group included 354 persons (55.2%). Age, prehospital delayed time and number of related chronic diseases were risk factors for serious disability (p<0.05). Conclusions: Our results indicate that the degree of disability can be reduced by decreasing prehospital delayed time. We suggest that education of high risk groups and establishment of emergency services as well as a transport system for stroke patients are required to reduce the degree of disability due to stroke.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.10
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• pp.222-230
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• 2018

This was a retrospective study that compared the characteristics of patients with decreased mental status (DMS) during their stays in an emergency department (ED) with that of patients with alert mental status (AMS). The participants in this study consisted of 90 patients with DMS who were staying in an ED along with 100 randomly selected patients with AMS. The DMS group contained more instances of cerebrovascular disease, liver disease, diabetes, and hypertension compared to the AMS group (p=0.001, p=0.003, p<0.001, and p=0.002, respectively). With regard to triage, the DMS group had higher severity than the AMS group (p<.001). The final diagnosis for the DMS group was as follows: 64.9% neurological and 63.3% related to the digestive system, which differed from that of the AMS group (p<.001). Fifty-six (62.2%) patients with DMS had their statuses discovered by nurses, while nine patients in the DMS group had received cardiopulmonary resuscitation. These results suggest that ED nurses frequently assess the consciousness of patients who they suspect may have neurologic or digestive diseases and are classified as high severity, even when the patients are alert.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.12
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• pp.5715-5721
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• 2011

This research analyzed the cognitive factors affecting stroke patient's activity of daily living performance and suggests the approaches which can contribute to the effective activity of daily living performance in the rehabilitation treatment of stroke patients. In this study, Seoul Computerized NeuroCognitive Function Test (SCNT) and MBI have been performed for 21 patients under extensive rehabilitation treatments, hospitalized in the rehabilitation clinic of A hospital after being diagnosed as a stroke caused by cerebrovascular disorders. To assess the effectiveness of the cognitive factors which affect the stroke patient's activity of daily living performance, activity of daily living performance values were set as dependent variables and 10 cognitive factors were included in the model to carry out analysis of the multiple regression analysis. The results show that stroke patient's activity of daily living performance have statistically significant correlations with divided attention, motor control and selectivir attention. In addition, cognitive factors explained 69.8% of the stroke patient's activity of daily living performance. Consequently, if divided attention and motor control are considered as a focal point of training in the rehabilitation treatment of stroke patients, we can effectively promote the improvement of the activity of daily living performanceroutine activities.

• Journal of Pharmaceutical Investigation
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• v.40 no.2
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• pp.117-123
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• 2010

Ibudilast, 3-isobutyryl-2-isopropyrazolo[1,5-a]pyridine, is a nonselective inhibitor of cyclic nucleotide phosphodiesterase (PDE). It preferentially inhibits PDE 3A, PDE4, PDE10 and PDE11 as well as a number of the other PDE families, albeit to a lesser extent. Ibudilast is used clinically to treat bronchial asthma and cerebrovascular disorders. Thes e clinical uses are based on the ability of ibudilast to inhibit platelet aggregation, improve cerebral blood flow and attenuate allergic reactions. The purpose of the present study was to evaluate the bioequivalence of two ibudilast capsules, Ketas capsule (Handok Pharmaceuticals Co., Ltd.) and Pinatos capsule (Sam Chun Dang Pharm. Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The in vitro release of ibudilast from the two ibudilast formulations was tested using KP Apparatus method with various dissolution media. Twenty six healthy male subjects, 23.31${\pm}$1.09 years in age and 70.45${\pm}$8.51 kg in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After a single capsule containing 10 mg as ibudilast was orally administered, blood samples were taken at predetermined time intervals and the concentrations of ibudilast in serum were determined using HPLC/UV detector. The dissolution profiles of two formulations were similar in all tested dissolution media. The pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated, and computer programs (Equiv Test and K-BE Test 2002) were utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, Ketas, were 6.99%, -2.48% and 9.93% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.8791~log 1.1861 and log 0.8347~log 1.1199 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Pinatos capsule was bioequivalent to Ketas capsule.

• Journal of Home Health Care Nursing
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• v.5
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• Journal of Preventive Medicine and Public Health
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• v.34 no.1
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• pp.1-8
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• 2001

Objectives : To gather information about the factors which influence the interest and intention of admission into charging nursing hones for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. Methods : A face-to-face interview survey was carried out with 320(men 159, women 165) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. Results : The mean age and years of education of the study population was 67.0 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children id the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission$(3.07{\pm}1.39)$ into a CNH was lower than that of interest$(3.22{\pm}1.33)$(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons$(\beta=-0.107)$, lower level of activity in daily life$(\beta=-0.447)$, and longer years of education$(\beta=-0.447)$ with 32.7% of $R^2$. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred 'elderly hospital' or 'elderly health center' to CNH. Conclusions : Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, though CNH.

• Journal of the Korean Society of Radiology
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• v.13 no.5
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• pp.713-720
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• 2019

The purpose of this study was to propose a new measurement method for accurate measurement of vessel diameter in computed tomography angiography(CTA). CTA test was performed after non-ionic iodine contrast agent was flowed at a constant rate to self-maded perfusion phantom. After obtaining raw data, images were reconstructed with multi-planar reconstruction(MPR) and maximal intensity projection(MIP). Diameters of vascular models were measured for each technique. Relative and conventional measurements were then compared. The mean diameter of the vascular model was closer to the actual measurement when relative measurement was used compared to that when conventional measurement was used both in MPR and MIP. Relative measurements of MPR and MIP were closer to actual measurement than those of conventional measurement (34% VS, 24%, p<0.05). The relative measurement method proposed in this study was closer to the actual measurement than the conventional measurement method. However, both test methods were still larger than actual results. Therefore, further study of relative measurement method is needed using this study as basic data.

• Journal of Korean Neurosurgical Society
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• v.65 no.6
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• pp.816-824
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• 2022

Objective : Emergency superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis in patients with large vessel occlusion who fails mechanical thrombectomy or does not become an indication due to over the time window can be done as an alternative for blood flow restoration. The authors planned this study to quantitatively measure the degree of improvement in cerebral perfusion flow using perfusion magnetic resonance imaging (MRI) after bypass surgery and to find out what factors are related to the outcome of the bypass surgery. Methods : For a total of 107 patients who underwent emergent STA-MCA bypass surgery with large vessel occlusion, the National Institute of Health stroke scale (NIHSS), modified Rankin score (mRS), infarction volume, and hypoperfusion area volume was calculated, the duration between symptom onset and reperfusion time, occlusion site and infarction type were analyzed. After emergency STA-MCA bypass, hypoperfusion area volume at post-operative 7 days was calculated and analyzed compared with pre-operative hypoperfusion area volume. The factors affecting the improvement of mRS were analyzed. The clinical status of patients who underwent emergency bypass was investigated by mRS and NIHSS before and after surgery, and changes in infarct volume, extent, degree of collateral circulation, and hypoperfusion area volume were measured using MRI and digital subtraction angiography (DSA). Results : The preoperative infarction volume was median 10 mL and the hypoperfusion area volume was median 101 mL. NIHSS was a median of 8 points, and the last normal to operation time was a median of 60.7 hours. STA patency was fair in 97.1% of patients at 6 months follow-up DSA and recanalization of the occluded vessel was confirmed at 26.5% of patients. Infarction volume significantly influenced the improvement of mRS (p=0.010) but preoperative hypoperfusion volume was not significantly influenced (p=0.192), and the infarction type showed marginal significance (p=0.0508). Preoperative NIHSS, initial mRS, occlusion vessel type, and last normal to operation time did not influence the improvement of mRS (p=0.272, 0.941, 0.354, and 0.391). Conclusion : In a patient who had an acute cerebral infarction due to large vessel occlusion with large ischemic penumbra but was unable to perform mechanical thrombectomy, STA-MCA bypass could be performed. By using time-to-peak images of perfusion MRI, it is possible to quickly and easily confirm that the brain tissue at risk is preserved and that the ischemic penumbra is recovered to a normal blood flow state.